THE CAUSES & DIAGNOSES OF BACK PAIN
MOST LOWER BACK PAIN IS NOTHING MORE SERIOUS THAN A SPRAIN, STRAIN OR IRRITATED NERVE. SERIOUS CAUSES SUCH AS SPINAL STENOSIS AND TRAPPED NERVE ARE RARE
If you’ve suffered back pain that won’t go away you might have had an MRI scan (pic right) to ascertain what’s causing the damage. Whilst undoubtedly very useful, MRI information must be taken in context.
How Useful Are MRI Scans?
MRI heralded a new future in diagnosing musculoskeletal pain when it was introduced in the NHS in 1980s. It pro-mised a new dawn of under-standing of the mechanics of pain. Only it didn’t. A landmark study in the New England Journal Of Medicine (1994) took 98 healthy individuals suffering no back pain. These poor unfortunates were subjected to the discomfort of an MRI machine and the results analysed. So given no pain you’d have thought they’d all have no structural abnormalities in their back? Well, no. A whopping 52 had a disc bulge. If disc bulges and protrusions don’t (necessarily) cause pain what does?
So What Are The Causes of Back Pain?
Back Pain is caused by three main dysfunctions; muscular, joint (disc and bone) and nerve.
If this pattern sounds familiar you may have a dysfunction in the muscles of the back: You wake up stiff. The first few minutes of the day you still feel stiff. As mid morning approaches the pain eases somewhat. Gentle exercise may make it feel better as movement is good for muscle pain. However, bear in mind that too much exercise, or the wrong kind of exercise, can aggravate already dysfunctional muscles. By the end of the day the pain has likely returned.
In my clinic muscular dysfunctions are identified in three ways; through palpation (touch), strength testing of the muscle and checking the range of movement of muscle. Muscular pain tends to respond quicker to acupuncture treatment.
2) Joint (Disc And Bone)
This sort of pain will likely linger all day. If you’ve herniated a disc low down in your back you may feel better bringing your knees in to your chest as this creates space around the disc. Standing or sitting can aggravate the affected joint and increase pain, as the load of the spine pushes on the dysfunctional joint.
Acupuncture cannot cure the dysfunction of the spine (such as a herniated disc) but it may improve pain levels by improving blood flow and reducing inflammation in the area.
Referred pain down the leg is a tell-tale sign of neurological (nerve based) pain but not a 100% cast iron diagnosis. Pain can refer down the side and back of the leg from dysfunction of the glutes or piriformis muscles.
Weakness of the leg, numbness and tingling or changes in bowel and bladder habits suggests there may be significant nerve damage. In this case go straight to A & E. The following also need urgent investigation:
Abdominal pain, which refers in to the back might be suggestive of an aortic aneurism.
Pain with fever, chills, nausea suggests there may be localised infection in the spine.
The Multifaceted Nature Of Pain
Whilst I have split pain into 3 main sections above, patients unfortunately don’t often neatly fall into one category or the other. For example, a protruding disc can push on a nerve causing pain. This pain can cause muscles to contract resulting in increased pain. In this case you’ve got joint and muscle working in tandem to create pain. Social and emotional factors are important as well. High levels of stress, anxiety, isolation or abuse can all amplify existing pain levels further.
www.goweracupuncture.co.uk / 07764 254881